About PPNI

Introducing Our Premier Provider Network

The Premier Provider Network, Inc. (PPNI) is one of America's largest and most comprehensive and diversified Provider Access Organizations (PAO). As such, network Providers agree to charge preferred lower prices in exchange for new Patients and "secure payments". By providing affordable alternatives to the traditional high costs of health insurance, and by supporting a pay-at-time-of service policy for all our Providers, PPNI creates an environment where healthcare Providers dramatically increase their cash-pay patient loads and revenue, and families can finally afford the healthcare they need.

PPNI contracts Providers in all states with the exception of Illinois. It also contracts in Guam and Puerto Rico. PPNI currently has contractual agreements with over 400,000 Providers nationwide that serve consumers. The PPNI network markets your services to various Member Associations that will place you at the forefront of a very competitive marketplace. PPNI's discount healthcare approach provides an innovative alternative to the rapidly increasing high cost of healthcare and benefits both network Providers and consumers.

The PPNI Provider Network features a national network of medical Providers comprising of Primary, Specialty and Ancillary Services.

PPNI offers the "best of both worlds"; whereas its roots and heritage date back to 1983 as the first Provider Access Organization (PAO), it embraces and utilizes state of the art technology of automated claim re-pricing, which provides your staff with the contract fee to charge the Member at the time of service.

PPNI provides strong financial incentives for Members to seek care from network participating Providers. Members must use PPNI Network participating Providers for all medical care in order to receive a discount on services.

This thoroughly integrated medical delivery system offers national strength, leverage and flexibility, with loyal community access; by region, state-by-state or nationwide, for complete participant satisfaction.

Benefits Our Providers Enjoy

• No network participation fee. There is no cost involved. It's 100% free!
• No claims to file just call our Claims Department and obtain the repriced amount by phone while the patient is in the office. Collect the discounted amount at the time of service.
• No claim form is required for most services. Claim forms may be required for accidents and some office visit reimbursement plans.
• No billing or administrative hassles or costs.
• Our fully trained staff appreciates your time and strives to provide world class Provider support services on each and every interaction.
• Payment is made at time of service. Patients do not need a referral to see participating physicians but we encourage Members to contact us for the most up to date listings.
• Increase in cash-paying patient volume.
• Dedicated agents market your services to new Member associations.
• We refer you new patients which helps increase cash flow and increase patient volume.

What is PPNI?

The Premier Provider Network, Inc. (PPNI) is one of America's largest and most comprehensive and diversified Provider Access Organizations (PAO). As such, network Providers agree to charge preferred lower prices in exchange for new Patients and "secure payments". By providing affordable alternatives to the traditional high costs of health insurance, and by supporting a pay-at-time-of service policy for all our Providers, PPNI creates an environment where healthcare Providers dramatically increase their cash-paying patient loads and revenue, and families can finally afford the healthcare they need.

Is PPNI national?

Yes. PPNI contracts providers in all (50) fifty states, Guam and Puerto Rico. PPNI currently has contractual agreements with over 400,000 providers nationwide that serve consumers. The PPNI network markets your services to various Member Associations that will place you at the forefront of a very competitive marketplace.

How do I add a new partner within my practice to the PPNI Network?

PPNI can mail or e-mail the Provider Agreement and Provider Applications to the Provider for completion. You may also choose to download our New Provider Packet.

Will I be charged a fee to enroll in the PPNI network?

No. Unlike other networks, PPNI does not charge participation or credentialing fees.

How will I receive referrals of Members from PPNI?

Your name will be printed in our directories, on our website and will be referred out through the Customer Care Center when Members call for Provider participation and availability information.

What are the Credentialing Requirements to join the PPNI network?

The Providers must have a valid license in the state in which they practice, proof of liability insurance and no practice restrictions. See Criteria for Provider Participation

Will my contract automatically renew from year to year?

Yes. PPNI's contracts automatically renew annually. A Provider must send notification in writing should they wish to terminate the Agreement. The contracts have a sixty-day term clause.

How do I bill for PPNI Members?

This is not an insurance product, therefore no claim forms are necessary. Simply bill the Member the contracted rate at the time of service. If you are unclear of the contracted rate, PPNI can assist you.

How did my name get referred out if I do not have a contract with PPNI?

Many Providers in our database are with one of our affiliate networks. We access these networks contractually in order to enhance our own for our Members.

How will I identify a Member of your program?

The Member will present an identification card. Examples of these cards are mailed to the provider in their implementation packet when the Provider contracts. You may also contact Customer Care at 1-800-323-4057 for Member Eligibility.

What are the advantages of being a Provider in the PPNI Network?

Some of the benefits to provider participation are as follows:

• Increased cash pay patient volume
• No billing or administrative hassles or costs
• Payment at time of service
• No claim forms
• No network participation fee
• No eligibility verification
• PPNI patient referral
• Dedicated agents to market Provider services to new associate Members

Does PPNI pay claims?

No, we are not a claims paying agent. Our network is not an insurance plan, but a preferred Provider medical savings program being offered through our affiliated Member associations to your community as an alternative to high insurance premiums. The Member pays at the time of services are rendered.

Can I perform lab, x-ray, physical therapy and other such procedures in my office or must I refer out?

Yes. These procedures may be performed within the Provider's office as long as the staff is licensed and qualified to perform such services. The contractual discount must be given to the Member for these services.